anyone heard of Purines being a possible trigger for flares? (warning - turkey is high in purines)

Before RA diagnosis - 3 years ago on boxing day I was out walking and remember being hit with intense pain in feet, lasted for one day, 2 years ago on Xmas day I was crying with pain this time in wrists, following that year my RA appreared, last Xmas day I was fantastic, in medically induced remission, no pain whatsoever (I was taking Enbrel and MTX)

So this year, I have been off MTX due to low WCC, 22nd Dec I went out to a party night, felt 100%, danced, wore a decent 4inch heel and ran for the taxi at end of night!

Next morning I started to flare but unlike the usual RA pain, this was far worse and very like I experienced 2 and 3 years ago, both times after eating turkey. I put it down to having a few drinks, having too much fun ect.. then almost within an hour after xmas dinner turkey I had to reach for the tramadol as I was in so much pain, it settled, then turkey for boxing day again and I was in extreme pain again.

Stupidly, it took me another day of turkey to realise the trigger, now I haven't touched it and I'm starting to feel myself again.

I've been googling this and it seems that food high in Purines can trigger flares.

I also found a report that MTX reduces the amount of Purines in our blood! this explains why last year (maybe) the turkey didn't have the same affect??

Bacon is also high, which I ate tons of this year!

any thoughts anyone?

[cris1728]

Hi Wiliby as you are describing the pain as being different to your RA pain could it be that it is an attack of gouty arthritis, this is more usually associated with foods high in purines and the subsequent raised uric acid level from the breakdown of the purines. I am not sure that the turkey is a food that is particularly high in purines although red meats, fish and alcohol are. It may be worth mentioning this to your Rheumy team. Have you had your urate level measured?

The fact that the pain settles quite quickly is more in keeping with a gouty problem than an RA flare. Whilst I know that there has been some research into purines and RA I do not know of any firm conclusions and associations and as people who have RA have other medical problems they may also have gout.

hope you get this sorted and gentle hugs crisxx

[Hidden in reply to cris1728]

yep, I think after reading yours and Polly's answer, you could be right. The other thing I noticed is that I never had any stiffness. Will mention it to GP whenever I see her next. I found a chart with foods that are high in Purines and think I keep it in mind from now on.

Thanks cris, I was gutted after being so well for so long but if it is gout then I can at least manage that!

haha, I though only old alcoholic fat men got gout and I'm only oldish!! apologies if thats offensive, I should know better having RA and some people being ignorant of that!! x

[cris1728 in reply to Hidden]

Hi Wiliby the other things that come to mind are that recent weight loss can trigger an attack of gout as can dehydration and you mentioned recently that you have had some weight loss.The foods that are high in purines are not all contributing factors in triggering an attack of gout and it is really quite complex but the animal protein foods which are high level are more of a risk than the vegetable foods and pulses. Also the seafood is not always a link. There are some foods which are supposed to help these are Oats, berries and cherries ( and probably some others) hope this helps.

[helixhelix]

Well foods high in purines breakdown into uric acid in your body, and high uric acid can trigger gout.....and gout is also an autoimmune disease with similarities to RA.....so there's a sort of sense to it. How are your toes? (I think I'd struggle more with 4 inch heel that a few helpings of turkey...). Px

[Hidden in reply to helixhelix]

Hi Polly, I think as I said to cris, I'll get it checked out.

Haha my toes are fine my heels are toeless and a size bigger than my usual size, felt great wearing them!

back to purines, this time of year I do eat far more than normal, I love turkey and all the trimmings, chocs ect so makes sense my purine levels will be raised.

Thanks again x

[Hidden]

This is really interesting Williby - I didn't know that turkey was high in purines. I was told ages ago that nuts are high and until recently I had been eating a mix of nuts in my breakfast cereal but stopped because of the foul taste which I thought they were causing. My dad had very bad gout - but he did eat rich food and drank too much - until latterly when he became diabetic and was forced to change his food intake radically after a heart attack (he also had arrhythmia).

I too thought only people like my dad (not fat or old but not thin either and definitely a foodie and a boozer in his youth!) got gout - men mostly. But a friend told me she gets arthritis in her hands really badly if she eats nuts so I asked my GP. Once diagnosed with RA I've only worried about food in relation to general health and weightloss. But I've happily indulged in turkey and all the trimmings - (put on about 3lbs at least) and am now wondering if this might account for increase of aches and pains?

Generally speaking I'm healthier now, since being on MTX, than I was before - less colds and overall health. Hmmm interesting thanks. Glad your flare has died away and next year maybe find an alternative to turkey! X

[Hidden]

Wilby i was looking at uric acid in foods over the past year when i was trying to get a herbal response to ra. i don't eat meat or fish so i didn't have to cut out a lot - as someone mentioned while alcohol does not have a very large amount it is something that exacerbates gout.

I didn't find it too hard as i had to leave out red meat, tuna fish and wierd things like mushrooms and asparagus oh and brocolli. The biggest problem i had was keeping bread out my diet, yeast is another source.

There are also foods that you can eat which are beneficial like tomatoes but that is also a food that can exacerbate joint pain. It is a mine field - i was trying a raw diet for a while but that was so difficult to keep up. I don't know if i was on the raw diet for too short a time but I honestly can say that i didn't find much of a difference. I will of course start the new year with another eating plan to combat weight gain and pain.

i do beleive that diet must have something to do with it so i keep taking a look at food and pain.